Management of acute heart failure in the intensive care unit

Pediatric heart failure (PHF) is a heterogeneous syndrome arising from varied etiologies including congenital heart disease, genetic, infective, inflammatory, and metabolic disorders. The aim of acute heart failure (HF) management is to achieve euvolemic state with adequate cardiac output and periph...

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Main Authors: Chidhambharam Lakshmanan, Priyavarthini Venkatachalapathy, Parvathy S. Menon, R. Vikram Rajkumar
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-05-01
Series:Journal of Pediatric Critical Care
Subjects:
Online Access:https://journals.lww.com/10.4103/jpcc.jpcc_22_25
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author Chidhambharam Lakshmanan
Priyavarthini Venkatachalapathy
Parvathy S. Menon
R. Vikram Rajkumar
author_facet Chidhambharam Lakshmanan
Priyavarthini Venkatachalapathy
Parvathy S. Menon
R. Vikram Rajkumar
author_sort Chidhambharam Lakshmanan
collection DOAJ
description Pediatric heart failure (PHF) is a heterogeneous syndrome arising from varied etiologies including congenital heart disease, genetic, infective, inflammatory, and metabolic disorders. The aim of acute heart failure (HF) management is to achieve euvolemic state with adequate cardiac output and peripheral perfusion. Management is guided by the severity of HF and assessment of volume and perfusion status of the patient. This includes pharmacological interventions such as diuretics, inotropes, vasodilators, timely, and appropriate use of invasive and noninvasive ventilation. Early achievement of these goals will help avoid deleterious effects of inotropes on already failing myocardium and a smooth transition to oral HF medicines. In children who are not stabilized with medical management, early initiation of mechanical circulatory support (MCS) including extracorporeal membrane oxygenation and ventricular assist devices, before onset of significant organ dysfunction should be considered. MCS serves as a bridge to recovery or transplantation or decision-making or occasionally as destination therapy.
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publishDate 2025-05-01
publisher Wolters Kluwer Medknow Publications
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series Journal of Pediatric Critical Care
spelling doaj-art-c42458daaa574aef907b5352a90af0d92025-08-20T02:44:28ZengWolters Kluwer Medknow PublicationsJournal of Pediatric Critical Care2349-65922455-70992025-05-0112313414210.4103/jpcc.jpcc_22_25Management of acute heart failure in the intensive care unitChidhambharam LakshmananPriyavarthini VenkatachalapathyParvathy S. MenonR. Vikram RajkumarPediatric heart failure (PHF) is a heterogeneous syndrome arising from varied etiologies including congenital heart disease, genetic, infective, inflammatory, and metabolic disorders. The aim of acute heart failure (HF) management is to achieve euvolemic state with adequate cardiac output and peripheral perfusion. Management is guided by the severity of HF and assessment of volume and perfusion status of the patient. This includes pharmacological interventions such as diuretics, inotropes, vasodilators, timely, and appropriate use of invasive and noninvasive ventilation. Early achievement of these goals will help avoid deleterious effects of inotropes on already failing myocardium and a smooth transition to oral HF medicines. In children who are not stabilized with medical management, early initiation of mechanical circulatory support (MCS) including extracorporeal membrane oxygenation and ventricular assist devices, before onset of significant organ dysfunction should be considered. MCS serves as a bridge to recovery or transplantation or decision-making or occasionally as destination therapy.https://journals.lww.com/10.4103/jpcc.jpcc_22_25diureticsinotropesmechanical circulatory supportpediatric heart failure
spellingShingle Chidhambharam Lakshmanan
Priyavarthini Venkatachalapathy
Parvathy S. Menon
R. Vikram Rajkumar
Management of acute heart failure in the intensive care unit
Journal of Pediatric Critical Care
diuretics
inotropes
mechanical circulatory support
pediatric heart failure
title Management of acute heart failure in the intensive care unit
title_full Management of acute heart failure in the intensive care unit
title_fullStr Management of acute heart failure in the intensive care unit
title_full_unstemmed Management of acute heart failure in the intensive care unit
title_short Management of acute heart failure in the intensive care unit
title_sort management of acute heart failure in the intensive care unit
topic diuretics
inotropes
mechanical circulatory support
pediatric heart failure
url https://journals.lww.com/10.4103/jpcc.jpcc_22_25
work_keys_str_mv AT chidhambharamlakshmanan managementofacuteheartfailureintheintensivecareunit
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AT rvikramrajkumar managementofacuteheartfailureintheintensivecareunit